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Philosophical Puzzles Resolved
Daniel Wikler posed to me the following problem he encountered while Staff Ethicist at the WHO.1The WHO recommends two principles: first, treat all citizens equally; second, aim to maximize overall quality of life. But imagine two citizens will die without a kidney transplant, one of whom is seriously disabled, but there is only one kidney. The first principle requires that both have an equal chance of getting the kidney. But the second principle requires we give it to the non-disabled person: if the disabled person dies, overall quality of life in the society will be higher, since it will have one less disabled person. (We accept, by definition, that disability lowers quality of life.) What to do?
Response:It seems pretty clear that the first value is simply wrong. We have no interest in promoting the health of the population; the population is simply an abstraction. Our interest is in promoting the health of (the sum of) individual people, who are conscious and therefore have moral interests.
One can see this clearly by looking at the cases where the population changes but people do not: birth, death, exile, and immigration:
Birth:The society has a controlled population growth program and assigns birth permits; birth permits are assigned to parents with the healthiest genes.
Death:The society has a limited number of organs; organs are given to the least-injured.
Exile:Sick people are tossed out of the society.
Immigration:Only healthy people are allowed to immigrate.
In all four such cases, it seems pretty clear to me that the population health position is wrong. (Exile seems particularly cruel.)
Derek Parfitposesthe following problem. 1: Imagine there are a group of happy people (A). 2: Now imagine that some other people are created in some other completely unconnected place that are happy, but less happy than the previous group (B). 3: Now imagine that both groups are adjusted to be at some equal, but intermediate point of happiness between A and A+. 4: Now imagine these two societies are connected, resulting in C: more people at a lesser degree of happiness.
2 is no worse than 1, since the additional people are happy and do not affect anyone. 3 is no worse than 2, since the people in B are made happier by more than the people in A are made unhappy. 4 is no worse than 3, since we are simply introducing folks to each other. But continue this and you reach the repugnant conclusion: a huge swarm of people who are just barely happy is better than a handful of people who are extremely happy.
Response:The problem is step 2, which is in fact worse than 1. Parfit assumes that simply adding extra people whose lives are worth living cannot make things worse. But that’s ridiculous. Imagine our society, then imagine our society with a bunch more feral people living on the huge island of garbage in the middle of the Pacific, unable to speak except in a growl, with none of the surrounding societies ever noticing. I think the people living in the garbage heap’s lives would be worth living (I wouldn’t want to kill them, nor would they want to be killed), but I distinctly prefer the former society.
Many people say that we shouldn’t eat animals, because that would mean killing them. But for many of these animals, if they aren’t going to be killed and eaten, they would never be born in the first place. What if the animal preferred to have a short, pleasant existence before being consumed as food rather than having no existence at all? Wouldn’t that mean we should breed the animal, give it a nice life, then kill and eat it?
Response:This is a ridiculous hypothetical — you’re suggesting an animal that doesn’t exist yet has a preference about existing. I don’t respect hypothetical creatures’ hypothetical desires to not be hypothetical. If I did, you could get me to do all sorts of absurd things just by hypothesizing them. You could, say, simply hypothesize a utility monster’s very strong desire to exist and I would be morally bound to try to create one. Or perhaps my hypothetical children really want to exist, so I have to hurry to procreate. That’s ridiculous.
I think we should maximize the actual interests of actual people.
As a consequentialist, if I support not adding people (as I do in my resolution to 2 and 3), then I must support removing people, since the consequences are identical. If I prefer a society with fewer, happier people, then I must support euthanizing some people to make the rest better off. Sure, there are practical questions with implementing this, but philosophically, I must be in favor of eliminationism.
Response:I am not a consequentialist about societies, I’m a utilitarian: I think we should work toward outcomes that maximize the interests of individuals.
There’s a fundamental disanalogy between addition and contraction. Addition means creating new people with interests that didn’t exist before the addition. Contraction, on the other hand, means getting rid of actually-existing people. I do not respect the hypothetical interests of hypothetical individuals to not be hypothetical, but I do respect real people with real interests right now, who presumably have an interest in not being gotten rid of. Thus, I support not getting rid of people and not arbitrarily creating new ones.
The problem is also discussed in F.M. Kamm, “Disability, Discrimination, and Irrelevant Goods“ ↩
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March  8, 2010